#040. The Brain Believes in Second Chances

On neuroplasticity and taking anti-depressants

In my visions, I was going to be the poster child of life after cancer, surgery, and hypothyroid recovery - walking around with a smile so bright you’d have to squint around me. Instead, the skies darkened with the clouds of a hypothyroid-induced depression everywhere I went.

Oh, make happy brain chemicals? I didn’t get the memo. Build a future business? Heh, I could barely keep up with my own self-care¹. I was struggling to keep a single nostril above the waters of life, let alone swim towards the golden shores of health, happiness, and success.

Despite wallowing in my despair, I managed to keep a spark of faith alive. I owe it to cultivating a decades-long relationship with neuroplasticity. This is our elegantly designed brain’s ability to heal and reorganize itself after injury, illness, and even seemingly invisible dysfunctions like ADHD, dyslexia, or depression. This had to be evidence of divine second chances.

Except, the brain is like a Himitsu-Bako (Japanese Puzzle Box)², there’s nuance to unlocking the puzzle box that is paralelled in our life’s journey. Some moves have one simple step, while others have thirty complex ones.³ Each sequential move gets you closer to opening the box.

When the depression didn’t go away after my thyroid hormones stabilized, I needed to pivot my strategy. The dogma I had around how my recovery ought to look was keeping me stuck. I had to finally admit to myself that my next move may be to go see the psychiatrist rather than my usual go-to’s of exercise, meditation, bodywork, psychotherapy, or just the brute force of will.

Following the Buproprion breadcrumbs

She prescribed Buproprion Hydrochloride (generic Wellbutrin), which is an anti-depressant. When I finally got the prescription, I sat on it for another month before starting. Like many anti-depressants, this one came with a black box warning - aka suicide risk and an potential increase in symptoms that it’s supposed to treat.

I reassured myself that I would be tracking everything so hopefully I could pivot again if things went sideways.

Fortunately, within a month I started to notice improvements. I felt a little less sluggish in the morning, a little less annoyed with people, a little less impatient in traffic, and a little less distracted at work.

It was a 1/10 improvement, but it was also a clue!

Initially, I had wanted an ADHD medication because I believed that the depression was secondary to ADHD. My psychiatrist thought differently and gave me a choice between an SSRI and Wellbutrin. Although it wasn’t the plan, I chose Wellbutrin because:

1. Wellbutrin is also used as an off label treatment for ADHD. As opposed to a stimulant - which stimulates release of certain brain chemicals, an NDRI (Norepinephrine and Dopamine reuptake inhibitor) keeps chemicals in circulation longer, specifically dopamine (DA) and norepinephrine (NE).

2. Personal genomics showed me that I have gene variants that mean I may not produce enough DA or NE, the DA/NE receptors don’t work as well, and everything metabolizes faster. Meaning, the overall dopaminergic system is inefficient.

I’ve heard many first-hand horror stories of anti-depressants gone wrong. How is the lay public is supposed to know how to choose? I barely knew and I’m a functional medicine trained practitioner. Otherwise, I may as well have flipped a coin.

An Experiment in Personal Neuroplasticity

Seeing that the Wellbutrin was working, I had two options for things to work even better:

1. I could take a higher dose of medication. Or,

2. I could leverage my biology to prolong the medication’s effects while aiming for more permanent improvement.

Being a neuroplasticity groupie obligated me to the latter option. If this worked, I’d find the bottleneck in my biochemistry. Then I could create a plan for long-term sustainable change. Hopefully one day, I would no longer need the meds.

For reasons that are TLDR, I chose S-adenosyl-Methionine (SAMe), Methylcobalamin (methylated B12) and Methylfolate (methylated B9) to test my biochemistry. Maybe I didn’t have enough brain chemicals in circulation to start with. The sport of catch-and-release only works if there are enough fish to catch-and-release.

To my delight, the improvements were practically immediate. And drastic.

I slept less but felt more refreshed.

I finished projects. (A big deal for someone with too many creative open loops).

I felt calm, certain, and decisive.

I felt like me again. No actually, I felt like SuperMe. Wellbutrin was definitely a shortcut, but it was nice to avoid the detour for once.

The Brain Believes

“Nerves that fire together, wire together,” and “Perfect practice makes perfect.”

You’ve likely heard these echos of neuroplasticity in the wild - whether in leadership development, sports psychology, or the education sphere. How do you learn a new skill, or how do you make what is good even better? Neuroplasticity is how transformations in mindset, behavior, skill, and identity become lasting and self-perpetuating - for better or for worse.

But like a self-winding watch, there is a minimum wind-up period. Consider that if neuroplasticity is like a self-winding watch, and the dopaminergic system is our internal systems of motivations and rewards, then rewiring yourself to live authentically IS the self-winding mechanism.

This wasn’t just about reorganizing my life, it was about healing it. Wellbutrin could only give me some of that potential energy, the other part was making choices that brought my life into 100% integrity with myself.

• Who do I want to be?

• How do I want to feel?

• Who do I want to surround myself with?

• Where do I want to live? To travel?

• What’s the meaning that I want to create in my life?

• What does happy, healthy, and successful look like for me?

Second chances are really about living authentically.

I ended up taking Wellbutrin for seventeen months, with two false stops before a final full stop. During that time, I made a plan to leave my job, hired an ADHD coach, and added lifestyle, exercise, and dietary changes specific for an ADHD-leaning brain. Then two months ago I finally went on sabbatical and starting making plans for my future functional medicine practice. I may no longer on Wellbutrin, but I still feel like me. I’ll take it as a promising sign I’m on the right track.

This story isn’t over, but it feels good not just to have less of symptoms, but to have more of life by my design. To be back at the helm as the captain of my ship.

All this to say, “The brain believes in second chances.” You are literally wired for them. If you are seeking, just follow the breadcrumbs left for you by your biology, and you will find your way back to yourself too.

---

This was essay #3 from Write of Passage, an online course helping me to become a better writer. So much love and gratitude for

Siesta in the Storm

Morgan Kitzmiller,

Rick Lewis

,

Camilo Moreno-Salamanca

, and Ken Rice for the thoughtful feedback and special shout out to

Tim Sweetman

for helping me to double down on the shiny dime for this one!

1. This was written a year ago, before I started the anti-depressants.

2. https://yosegijapan.com/japanese-puzzle-box/

3. Snippet of a Japanese Puzzle Box in action